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(BOSTON) — Today, Community Catalyst released a new report that shows work requirements in states that have not expanded Medicaid are unworkable and would unfairly force individuals into the state’s coverage gap, causing them to lose health coverage. The report comes on the heels of today’s announcement by the Centers for Medicare and Medicaid that they will allow states to apply for waivers to institute work requirements for some Medicaid recipients.

The analysis, “Work Requirements: A One-Way Ticket to The Coverage Gap”, uses a 20-hour per week work requirement as a baseline to assess the impact on low-income households in non-expansion states. In most Medicaid non-expansion states, an individual who works 20 hours per week in a minimum wage position would earn too much money to continue to qualify for Medicaid coverage, but would earn too little to qualify for help purchasing coverage in the marketplace. For example, the analysis shows that if a family of four has two parents earning minimum wage, households in only three states – South Carolina, Tennessee and Wisconsin – would still qualify for Medicaid coverage.

“A work requirement directly conflicts with the underlying objectives of the Medicaid program and, we believe, is an illegal abuse of the Secretary’s waiver authority,” said Katherine Howitt, associate director of policy at Community Catalyst. “People who fail to meet a work requirement for whatever reason would be disenrolled from the program and lose access to the care they need. This will likely have the opposite of the intended effect, since good health is a prerequisite to finding and keeping a job.”

Work requirements in Medicaid non-expansion states place applicants in a ‘Catch-22,’ which only adds to the growing list of reasons why work requirements are untenable in Medicaid overall. Historically, work requirements in other programs have not been shown to help people gain or maintain employment, and they have proven to be burdensome and costly for states to administer.”

Today nearly eight in ten adults with Medicaid coverage are in working families, and nearly six in ten are working themselves. And of those who don’t work, over a third have an illness or disability – sometimes multiple physical and mental illnesses – that prevents them from doing so; others are taking care of young children or sick relatives, or are going to school. The work requirement would add heavy reporting and paperwork burdens on these families, and result in many people losing coverage merely because they were not able to navigate this new layer of red tape.

“The logic behind this new policy seems straight out of Alice in Wonderland, where the administration is saying work is good for your health, but failing to meet a work requirement means you will lose your health insurance,” Howitt said. “After spending the last year trying to take health care away through multiple attempts to repeal the Affordable Care Act and cut Medicaid, the Trump administration has now turned to state Medicaid waivers in a blatant attempt to place barriers between people and the health care they need.

“The Trump administration should abandon this misguided and likely illegitimate policy that has no place in the Medicaid program. The decision to endorse this unprecedented policy is not about promoting work – it is about taking health coverage away from low-income people.”

Read the full analysis.


About Community Catalyst

Community Catalyst is a national, non-profit consumer advocacy organization founded in 1998 with the belief that affordable, quality health care should be accessible to everyone. We work in partnership with national, state and local organizations, policymakers, and philanthropic foundations to ensure consumer interests are represented wherever important decisions about health and the health system are made: in communities, courtrooms, statehouses and on Capitol Hill. For more information, visit Follow us on Twitter @healthpolicyhub.